NPI | 1124284336 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD433643) |
Additional Taxonomies | 207ZC0006X Pathology, Clinical Pathology (Licence: VT 042.0011960) |
Enumeration Date | 2008-08-07 |
Last Update Date | 2018-08-31 |